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Oxford University 4th Year Medical Students
In December 2003 we were invited to visit Oxford University and run the study during a lecture to 4th year medical students. We had 58 students complete both questionnaires and of these 40 were able to look at the website inbetween, the other 18 serving as a control group. As would be expected, most students got most of the true/false statements correct as these were relatively basic for people with medical knowledge. There were, however significant changes in the attitudes to antibiotic use in acute otitis media. As mentioned on the previous page (Research page), this is an area of medicine where the evidence for and against prescribing antibiotics is far from clear and there were clear changes in the students attitudes towards the benefit of antibiotics in this common childhood ear infection with students less likely to expect antibiotics to be prescribed after looking at the website. A summary of the results is below. The results have been analysed and appropriate statistical tests performed including McNemars test, paired t-test and Wilcoxon's matched pairs test:








Knowledge changes
The following graph shows the percentage of students before and after using the website that got each statement correct. Please note that the correct answers are not indicated on this site as this may compromise future studies.


The only question for which there was a real improvement in the percentage of students answering correctly was the second statement but there was no difference between those who looked at the website and those who didn't suggesting that this change was not associated with the website.








Attitude Changes
There were clear changes in attitudes for all but one of the questions for those students who looked at the website compared with no significant changes for those who didn't view the site providing strong evidence that the website did influence student's attitudes to antibiotic prescribing in acute otitis media. The following graphs provide examples of the changes:

Are antibiotics effective in AOM?
The following chart shows the changes in attitudes to the statement "Antibiotics are effective in AOM" for those students who looked at the website. There are clear differences with more students tending to disagree with this after using the website.



Does the evidence show that doctors should prescribe antibiotics for AOM?


Again there are clear changes in attitudes with students less likely to think that the evidence supports antibiotic prescriptions for AOM after using the site.

Would you expect an antibiotic for AOM?


Knowing what the evidence suggests and what we therefore expect in our own situation are not always the same. This graph shows that there were decreased expectations of antibiotics for AOM if students or their families were affected themselves.








Conclusion

We can see from the above graphs that there were significant changes in attitudes to antibiotic prescribing in those students who looked at the website between completing the two questionnaires. This supports the results from the studies in the Science Museum and Nottingham City Hospital suggesting that the website does influence user knowledge and attitudes. The main difference with this group was the high standard of general knowledge with most students correctly answering the true/false questions. Knowledge and attitudes to antibiotic use in AOM was not as high prior to using the site, but this is to be expected as many students will not have encountered this infection in a clinical setting as yet, so be unaware of the difficulty surrounding decisions about antibiotic prescribing.
Our thanks to Dr Brian Angus and his 4th year medical students at Oxford University for their invitation and co-operation in this study.





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